Liver Cyst

V. Sreedhara*

Head, Department of Surgical Gastroenterology and General Surgery, Kauvery Hospital, Bangalore, India

*Correspondence: Email: sreedhara142@gmail.com

Background

Liver cysts can be diagnostic and therapeutic challenges to both clinicians and patients. Simple Liver cysts are the commonest of them. Ultrasound and MRI are diagnostic. Simple liver cysts are usually harmless and untreated

When Simple Liver cysts are more than 4 cm and symptomatic (pain), need Surgical intervention. Laparoscopic surgery is rarely performed & is best for patients and when done by experts.

Case Presentation

This video is of a pre-operatively suspected Duplication cyst (CT Scan) of the foregut in 65 years old female, with short stature and morbidly obese, who presented to OPD with complaints of severe right upper abdominal pain of 2 weeks duration. In spite of analgesics, her sleep was disturbed and her daily routine was disturbed.

On Evaluation

Afebrile, the pulse of 112 and normal BP and saturation

Per abdomen

Large right upper abdominal mass moving with respiration and minimal tenderness & dull on percussion, continuous with Liver dullness

Provisional diagnosis-large mass arising from the right lobe of the liver.

Tumour markers negative for malignancy

CT abdomen showed-large cystic mass in close relationship to pylorus and head of pancreas possibly duplication cyst of foregut.

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Plan of Action

Option 1: Resection with Billroth 1

Option 2: Laparoscopic decompression with mucosectomy

Per OP finding- hemorrhagic cyst arising from segment 2 of the left lobe of liver adherent to stomach, head of the pancreas, and omentum. Underwent resection of cyst. Post op period uneventful.

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Post OP image of surgery.

Youtube Video Link: https://youtu.be/P3_Qw-GxMk4

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